Neoadjuvant Chemotherapy Plus Cadonilimab for Locally Advanced Cervical Cancer

Histologically confirmed cervical carcinoma, FIGO stage IB3, IIA2, IIB, IIIC1, and assessed as resectable by the researcher。

Inclusion Criteria:

• Female, age ≥18 years;

• Histologically confirmed cervical cancer, FIGO stage IB3, IIA2, IIB, IIIC, andassessed by the researcher as resectable;

• No previous systemic treatment for the current disease, including surgicaltreatment, antitumor chemoradiotherapy/immunotherapy, etc.;

• Patients who agree to undergo radical surgical treatment and are judged by thesurgeon to have no surgical contraindications;

• ECOG score of 0-1;

• Expected survival time >6 months;

• Sufficient organ function, the subject must meet the following laboratoryindicators:

Neutrophil absolute count (ANC) ≥1.5x10^9/L ; Platelets ≥100x10^9/L ;Hemoglobin >9g/dL ; Total bilirubin ≤1.5× upper limit of normal (ULN); Aspartate aminotransferase (AST), alanine aminotransferase (ALT) ≤2.5×ULN; Serum creatinine ≤1.5×ULN and creatinine clearance (calculated using the Cockcroft-Gault formula) ≥60 ml/min; international normalized ratio (INR) or prothrombin time (PT) ≤1.5 times ULN; Normal thyroid function; Myocardial enzymes within the normal range

Exclusion Criteria:

• Diagnosis of other malignancies within 5 years prior to the first dose (excludingadequately treated basal cell carcinoma of the skin, squamous cell carcinoma of theskin, and/or carcinoma in situ that has undergone radical resection).

• Current participation in an interventional clinical study or receipt of otherinvestigational drugs or devices within 4 weeks prior to the first dose.

• Prior treatment with anti-PD-1, anti-PD-L1, or anti-PD-L2 agents, or drugs targetingother stimulatory or co-inhibitory T-cell receptors .

• Systemic treatment with Chinese herbal medicines with antitumor indications orimmunomodulatory agents (e.g., thymosin, interferon, interleukin, excluding localuse for pleural effusion control) within 2 weeks prior to the first dose.

• Active autoimmune disease requiring systemic treatment (e.g., disease-modifyingagents, glucocorticoids, or immunosuppressants) within 2 years prior to the firstdose. Replacement therapies (e.g., thyroxine, insulin, or physiologicglucocorticoids for adrenal/pituitary insufficiency) are not considered systemictreatment.

• Systemic glucocorticoid therapy (excluding nasal sprays, inhalations, or other localroutes) or any immunosuppressive therapy within 7 days prior to the first dose.

• History of allogeneic organ transplantation (excluding corneal transplants) orallogeneic hematopoietic stem cell transplantation.

• Known hypersensitivity to any study drug.

• Presence of multiple factors affecting cisplatin use (e.g., platinum allergy).

• Inadequate recovery from prior intervention-related toxicity or complications (i.e., >Grade 1 or not returned to baseline, excluding fatigue or alopecia).

• Known history of Human Immunodeficiency Virus（ HIV） infection .

• Untreated active hepatitis B （HBV）(defined as HBsAg-positive with HBV-DNA exceedingthe upper limit of normal at the study site).

• Active hepatitisC (HCV) infection (HCV antibody-positive with HCV-RNA above thelower detection limit).

• Administration of live vaccines within 30 days prior to the first dose (Cycle 1, Day 1).

• Pregnant or lactating women.

• Severe or uncontrolled systemic diseases, including:Symptomatic restingElectrocardiograph abnormalities (e.g., complete left bundle branch block, ≥Grade IIheart block, ventricular arrhythmia, atrial fibrillation).Unstable angina,congestive heart failure, or chronic heart failure ≥NYHA class II.Arterialthromboembolism, ischemia, myocardial infarction, unstable angina, stroke, ortransient ischemic attack within 6 months prior to enrollment.Poorly controlledhypertension (systolic >140 mmHg, diastolic >90 mmHg).History of non-infectiouspneumonitis requiring glucocorticoids within 1 year or current active interstitiallung disease.

• Active tuberculosis.

• Active or uncontrolled infection requiring systemic therapy.

• Clinically active diverticulitis, abdominal abscess, or gastrointestinalobstruction.

• Liver diseases (e.g., cirrhosis, decompensated liver disease, acute/chronic activehepatitis).

• Poorly controlled diabetes (fasting blood glucose >10 mmol/L).

• Urine protein ≥++ on urinalysis with 24-hour urine protein >1.0 g.

• Psychiatric disorders impairing compliance.

• Any condition (e.g., medical history, abnormal lab/test results, concurrenttreatments) that may interfere with study outcomes, participation, or pose risks, asjudged by the investigator.